Types of Feeding

8/6/2019 Types of Feeding

1/21

Enteral Feeding

y used for the delivery of nutrients via a tube

y Purposes:

y To restore or maintain nutritional status

y To administer medication


2/21

Purpose

y To restore or maintain nutritional status

y To administer medication


3/21

Standardsy Enteral feeding is ordered by medical officers

y Trained registered nurses and medical officers may

insert salem pump/fine bore gastric tubesyA salem sump tube is essential to allow monitoring of

absorption of feeds when first commenced

y Radiological verification of tube position is essential

before enteral feeding


4/21

y Only eight hours enteral feed in the bottle at any onetime

y Patients must be on a fluid balance chart whilstreceiving enteral feeding

y The tube must be securely anchored to the patientsnose

y The tube should be flushed with 10-20ml of sterileH20 before and after administration of medication

y Enteral feed giving set to be changed at 2000hrs daily


5/21

Outcomes

y Store enteral feed in refrigerator and do not use feedmore than 24 hours old

y The tube will not become malpositioned

y The patient will attain optimum nutrition from enteral

feeding by correct choice of feed type and volume


6/21


7/21

Types:y Nasogastric tube (NG-tube)

y An NG-tube is a small thin tube inserted through a personsnose, throat and down into the stomach.

*Nasojejunal tube or NJ-tube:

yGastrostomy Feeding (G-tube or peg tube)y G-Tubes are surgically inserted and removed with an

endoscope.

y Gastrostomy-Jejunostomy orGJ-tube (Transgastric-Jejunal

or TJ tube):y This is again like the G-tube and is surgically inserted, and

like the NJ-tube it is guided though the stomach down intothe jejunum.


8/21

y Balloon device (tube or button)y Buttons are used again for more long term in patients,

and tend to be more widely acceptable due to there lowprofile design.

y Jejunostomy orJ-tube:

y This is the same as both the NJ-tube and the GJ-tube,they make a surgical incision in the abdomen wall, thedifference is they bypass the stomach and go directlyinto the jejunum.

y Total parenteral nutrition (TPN):y is the practice of feeding a person intravenously, it

passes the usual process of eating and digestion.


9/21

Procedure

yAssist the client to a Fowlers position in bed or sitting

position in a chair, the normal position for eating. If asitting position is contraindicated, a slightly elevatedright side lying position is acceptable.


10/21

y Explain to the client what you are going to do, why it isnecessary, and how he or she can cooperate. Inform

the client that the feeding should not cause anydiscomfort but may cause feeling of fullness. For anadult, the usual intermittent feeding will take about 30min. the exact length of time depends largely on the

volume of the feeding.


11/21

ywash hands and observe appropriate infection controlprocedure.

y Provide privacy for this procedure if the client desiresit.


12/21

y assess tube placement.

y a. attach the syringe to the open end of the tube and

aspirate alimentary secretion. Check pH.y b. Allow one hour to elapse before testing the pH if the

client has received a medication

y c. Use pH meter rather than pH paper if the client isreceiving a continuous feeding or if food coloring hasbeen added to formula.


13/21

yAssess residual feeding contents.y aspirate all stomach contents and measure the amount

before administering the feedingy if 100 ml (or more than half the last feeding) is

withdrawn, check with the nurse in charge or refer toagency policy before proceeding the precise amount isusually determined by the physicians order or by agencypolicy.


14/21

yAdminister the feeding.

y before administering the feeding:

y Check the expiration date of the feeding Warm the feeding toroom temperature

y when an open system is used, clean the top of thefeeding container with alcohol before opening it


15/21

FEEDING BAG (OPEN SYSTEM)

y hang the bag from an infusion pole about 30 cm. (12in.) above the tubes point of insertion into the client.

y clamp the tubing and add the formula bag

y open the clamp, run the formula through the tubing,

and reclamp the tube. The formula will displace the airin the tubing, thus preventing the installation ofexcess air into the clients stomach or intestine.


16/21

y attach the bag to the nasogastric/nasoenteric tube and

regulate the drip by adjusting the clamp to the dropfactor on the bag.


17/21

SYRINGE (OPEN SYTEM)

y remove the plunger from the syringe and connect thesyringe to a pinched or clamped nasogastric tube.

y add the feeding to the syringe barrel.

y insert the feeding to flow in slowly at the prescribed

rate. Raise or lower the syringe to adjust the flow asneeded. Pinch or clamp the tubing to stop the flow fora minute if the clients feel discomfort.


18/21

PREFILLED BOTTLE WITH DRIP

CHAMBER(CLOSED SYSTEM)

y remove the screw on cap from the container and attach

the administration set with the drip chamber andtubing

y close the clamp on the tubing

y hang the container on an intravenous pole about 30

cm (12 in) above the tube insertion point into theclient.


19/21

y squeeze the drip chamber to fill it to one half of itscapacity

y

open the tubing clamp, run the formula through thetubing, and reclamp the tube

y attach the feeding set tubing to the feeding tube andregulate the drip rate to deliver the feeding over the

desired length of time. Prefilled tube feeding sets canbe attached to a feeding pump to regulate the flow.


20/21

y Rinse the feeding tube immediately before all of theformula has run through the tubing

y instill 50 to 100 ml of water through the feeding tube.Water flushes the lumen of the tub, preventing futureblockage by sticky formula.

y be sure to add the water before the feeding solution hasdrained from the neck of a syringe or from the tubing ofan administration set. Before adding water to a feeding

bag or prefilled tubing set, first clamp and disconnectboth feeding and administration tubes.


21/21

y Clamp and cover the feeding

y

clamp the feeding tube before all of the wter instilledy cover the end of the feeding tube with gauze held by an

elastic band

y Ensure client comfort and safety

y Dispose the equipment appropriately

y Document all relevant information

y Monitor client for possible problems

Types of Feeding

Documents

Transcript of Types of Feeding